The sacroiliac joint possesses all the characteristics of a true joint and can produce symptoms quite similar to facet joint abnormalities. Pain originating from the sacroiliac joint usually causes buttock and referral pain: hip, groin, anterior thigh and calf. The second sacral nerve level contributes heavily to the innervation of the sacroiliac joint and a second sacral nerve ganglionotomy can be an important adjunct to sacroiliac joint rhizotomy. The fact that capsule and ligaments contain nociceptors suggests that the sacroiliac joint is a possible source of low back pain and also plays a role in somatic referred pain. The patient usually experiences buttock discomfort and referred posterior thigh pain following a sacroiliac joint rhizotomy. We can lessen the residual symptoms after a sacroiliac joint rhizotomy by applying a second sacral nerve ganglionotomy. We experienced a patient with the sacroiliac joint originated pain who was successfully treated with sacroiliac joint rhizotomy and second sacral ganglionotomy without any residual sequelae and tolerates well after 4 months.